Causes and Risk Factors of Aortic Stenosis

Reviewed by: HU Medical Review Board | Last reviewed: May 2024

Aortic stenosis (AS) is a heart condition where the aortic valve narrows. The aortic valve is one of 4 main valves in the heart. Its job is to provide blood from the heart to the rest of the body. When the aortic valve narrows, it restricts blood flow throughout the body.1

AS is also sometimes called failing heart valve. If the condition is not properly treated, it can lead to serious health problems like heart failure and even death.1,2

Causes of aortic stenosis

There are several potential causes of aortic stenosis, including:1,2

  • Aging and age-related causes
  • Birth defects
  • Illness and other health conditions

Aging and age-related causes

Wear and tear due to age is the most common cause of AS. As people get older, calcium deposits can build up on their aortic valve. These deposits cause the aortic valve to stiffen and narrow, limiting blood flow from your heart to the rest of your body. The process is similar to the buildup of plaque in the arteries.1,2

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Age-related AS typically occurs in people who are 65 and older, though symptoms of AS may not appear until age 70 or 80. The likelihood of an AS diagnosis increases with advancing age. More than 12 percent of Americans currently have AS.1,2

Birth defects

Although rare, congenital heart defects are another possible cause of AS. Some people are born with an aortic valve that has only 2 valve flaps instead of 3 valve flaps. This is called a bicuspid aortic valve. Over time, this defect can lead to the valves not working well. AS then becomes a possibility.1,2

A bicuspid aortic valve may not cause any signs or symptoms until adulthood. But it sets people up to have earlier and sometimes more severe heart valve problems.1,2

Heart damage from infections

Certain illnesses also can lead to AS. For instance, untreated strep throat or scarlet fever can cause rheumatic fever. Rheumatic fever can damage the heart valves. AS due to infections usually takes years or even decades to develop.1-3

Other illnesses and conditions

Other related conditions that can worsen aortic valve problems include:1,2

  • Chronic kidney disease or kidney failure
  • Familial hypercholesterolemia, a genetic disorder that causes high cholesterol
  • Lupus
  • Paget’s disease, a bone disorder
  • Rheumatoid arthritis

Recognizing the signs and symptoms of aortic stenosis

Early detection of aortic stenosis is vital because it can be very dangerous if left untreated. Symptoms often develop gradually and can be mistaken for signs of other conditions or simply chalked up to aging. For others, AS can come on suddenly. AS can lead to heart failure or even death.1,2

Here are some signs and symptoms to watch for:1-3

  • Chest pain
  • Shortness of breath
  • Fatigue
  • Dizziness, lightheadedness, or fainting, often triggered by physical activity
  • Heart palpitations
  • Swelling of the ankles and feet

If you have any of the above symptoms, or if you notice that you can no longer carry out everyday activities, contact your doctor right away.

Can aortic stenosis be prevented?

AS that is caused by birth defects is beyond the person’s control. Age-related AS is also usually not something people can prevent altogether. That said, several actions may reduce your overall risk for AS. They include:2

  • Managing risk factors – Keep your cholesterol, blood pressure, and blood sugar in check.
  • Making healthy lifestyle choices – Eat a healthy diet, exercise regularly, maintain a healthy weight, and do not smoke.
  • Preventing infections – Infections like strep throat can go from bad to worse fast. Prompt treatment of these infections can help you avoid complications like rheumatic fever, which is a known cause of AS.
  • Getting regular medical checkups – Be sure you visit the doctor regularly. And be sure to tell your doctor if you have any symptoms that concern you.

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